[Hiring] Clinical Strategy and Program Development Lead @Humana

Role Description

Become a part of our caring community. The Clinical Performance Strategy & Measurement Team shapes how Humana defines, measures, and improves clinical performance across the enterprise. By identifying high-impact opportunities to improve healthcare quality, affordability, provider performance, and member outcomes, the team informs enterprise strategy and drives meaningful change across the healthcare ecosystem.

The Clinical Strategy and Program Development Lead develops and advances enterprise clinical strategies that improve healthcare quality, affordability, provider performance, and member outcomes. This role identifies and evaluates high-impact opportunities, assesses performance gaps, and develops clinical performance frameworks and quality measures.

• Identify and evaluate opportunities to improve clinical performance across priority populations and specialties.
• Conduct strategic assessments of clinical performance and measurement gaps.
• Conduct specialty landscape analyses to inform future investment decisions.
• Develop business cases, strategic recommendations, and adoption approaches for new clinical initiatives.
• Maintain strategic roadmaps that prioritize future clinical performance opportunities.
• Own and maintain a pipeline of future clinical performance opportunities.

This position plays a key role in shaping Humana's long-term clinical performance strategy by identifying emerging opportunities, developing strategic roadmaps, advancing innovative measurement approaches, and creating scalable solutions that deliver sustainable enterprise value.

Qualifications

• Bachelor's degree.
• 8+ years of experience in healthcare strategy, clinical strategy, healthcare consulting, population health, provider performance, value-based care or quality improvement OR 4 years of experience from a top tier consulting.
• Experience developing strategic recommendations using quantitative and qualitative data analysis.
• Experience leading cross-functional strategic initiatives and driving results across multiple stakeholders.
• Experience partnering with analytics teams to analyze healthcare data and generate actionable insights.
• Experience developing business cases and presenting recommendations to senior leadership.
• Demonstrated ability to influence without direct authority.
• Strong executive communication, presentation, and storytelling skills.
• Self-starter with the ability to proactively identify opportunities, solve complex problems, and manage competing priorities.
• Demonstrated ability to navigate ambiguity and drive results in a fast-paced environment.
• Advanced proficiency in Microsoft Excel and PowerPoint.

Requirements

• Advanced degree (Master's or Doctorate) in Business (MBA), Public Health, Epidemiology, Healthcare Administration, Clinical Informatics, or a related field.
• Experience developing business cases, strategic roadmaps, and enterprise-level recommendations for healthcare programs and initiatives.
• Clinical degree or licensure (e.g., MD, DO, PharmD, APRN, NP, PA, RN, BSN).
• Knowledge of healthcare claims data, clinical coding systems and taxonomies (e.g., ICD-10, CPT, HCPCS), quality measurement methodologies, performance analytics, and their application to performance measurement and improvement initiatives.
• Experience working with Medicare Advantage populations.
• Experience synthesizing evidence from peer-reviewed literature, industry research, and healthcare trends to support strategic decision-making.

Benefits

• Medical, dental and vision benefits.
• 401(k) retirement savings plan.
• Time off (including paid time off, company and personal holidays, paid parental and caregiver leave).
• Short-term and long-term disability.
• Life insurance and many other opportunities.

Company Description

Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health.